title: Significance of preoperative serum CA-125 levels in the prediction of lymph node metastasis in epithelial ovarian cancer.
abstract: OBJECTIVE
  To investigate preoperative serum CA-125 levels as a predictive factor for evaluation of lymph node metastasis in epithelial ovarian cancer.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Medical records at Seoul National University Hospital.
  
  
  METHODS
  Ninety-nine patients with epithelial ovarian cancer between January 2004 and March 2007.
  
  
  METHODS
  The significance of the preoperative serum CA-125 level for the prediction of lymph node metastasis was determined using the receiver operating characteristic (ROC) curve, McNemar's test and logistic regression analysis. Clinical prognostic factors affecting survival were evaluated using the Kaplan-Meier analysis with the log-rank test and Cox's proportional hazard analysis.
  
  
  RESULTS
  The ROC curve showed the best cut-off value (535 U/mL) of the preoperative serum CA-125 level with regard to sensitivity (70.0%) and specificity (83.1%). Imaging studies combined with the preoperative serum CA-125 level showed the highest sensitivity (90.0%), whereas imaging studies alone showed the highest specificity (89.8%) for the prediction of lymph node metastasis. FIGO stage III-IV, the preoperative serum CA-125 level (> or =535 U/mL) and lymph node involvement on imaging studies were significant factors for the prediction of lymph node metastasis (p<0.05). Suboptimal debulking surgery and lymph node metastasis were poor prognostic factors for progression-free survival and overall survival, respectively (p<0.05).
  
  
  CONCLUSIONS
  The preoperative serum CA-125 level (> or =535 U/mL) may be important for the prediction of lymph node metastasis in patients with epithelial ovarian cancer. Furthermore, it can be helpful in selecting patients who should undergo systemic lymphadenectomy for the detection of hidden lymph node metastasis.
authors.affiliation: Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Kim
authors.forename: Noh Hyun
authors.initials: NH
authors.lastname: Park
authors.forename: Hyun Hoon
authors.initials: HH
authors.lastname: Chung
authors.forename: Jae Weon
authors.initials: JW
authors.lastname: Kim
authors.forename: Yong Sang
authors.initials: YS
authors.lastname: Song
authors.forename: Soon Beom
authors.initials: SB
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000401:mortality / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000097:blood* / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen